Thyroid ultrasound – how to interpret the results?

Interpreting the results of an ultrasound of the thyroid gland is quite a challenge. Complex medical nomenclature is often an insurmountable obstacle for most patients. If you would like to know what the result of your research may mean and how it can influence the further procedure, this article is for you!

Remember that the correct interpretation can only be made by an experienced doctor. This article is not intended to teach you a comprehensive interpretation of the result but only to explain the meaning of terms that are often used in the description of the test.

When is an ultrasound of the thyroid gland performed?

The main indications for an ultrasound of the thyroid gland are:

  1. assessment of palpable changes, especially nodules,
  2. assessment of the gland for abnormal hormonal test results (TSH, FT3 and FT4),
  3. a family history of thyroid cancer
  4. monitoring of previously detected nodules,
  5. suspicion of inflammatory diseases of the liver,
  6. evaluation of nodules after radioiodine treatment.

Check how the thyroid ultrasound is going and how to prepare for it

Selected terms used in the description of thyroid ultrasound

The following are some of the terms frequently used in the description of the study that pose a problem in understanding the meaning of the result. Remember to discuss any doubts about the result with the doctor who conducts or performs the test.

  1. Focal change on ultrasound of the thyroid gland

What it means: a single lesion (it can be a cyst or a solid tumor, among others) detected by ultrasound.

Interpretation: Denotes a general term that can indicate both a benign and malignant lesion.

  1. Hypoechoic change in thyroid ultrasound

Which means: on the ultrasound image, the lesion is darker than the surrounding area.

Interpretation: may indicate soft lesions with increased blood supply, which include, for example, solid tumors – they may be malignant or benign. In the case of thyroid nodules, the presence of a hypoechoic lesion is associated with a slightly higher risk of thyroid cancer.

Thyroid cancer – what do you need to know?

  1. Hyperechoic change in thyroid ultrasound

Which means: on an ultrasound image, such a lesion is brighter than the surrounding area.

Interpretation: This result indicates compact and hard lesions such as calcifications, bones, or gases.

  1. Calcifications on ultrasound of the thyroid gland

What they mean: there are microcalcifications (less than 2 mm) and macrocalcifications (more than 2 mm), these are clusters that accumulate in the nodules or parenchyma of the thyroid gland.

Interpretation: The presence of microcalcifications is associated with a higher risk of thyroid cancer.

Thyroid hormones. What do blood results say about thyroid disease?

  1. Heterogeneous thyroid parenchyma on ultrasound of the thyroid gland

Which means: the thyroid parenchyma should be homogeneous, uniform and normoechoic. Any deviations from this state indicate pathological changes.

Interpretation: the reasons for the heterogeneity of the thyroid parenchyma include, first of all, nodules, goiter, and fibrosis.

  1. Anechoic area on ultrasound of the thyroid gland

What it means: indicates the presence of a lesion that does not reflect ultrasound.

Interpretation: it most often indicates the presence of fluid (cyst).

  1. Abnormal size of the thyroid gland on ultrasound of the thyroid gland

Which means: properly, the size of the thyroid gland should be max 20 ml in women and 25 ml in men, its enlargement may indicate a goiter.

Read more about goiter of the thyroid gland

  1. Parenchymal goiter on ultrasound of the thyroid gland

Which means: it indicates an enlarged thyroid gland but with a homogeneous flesh and no nodules present.

  1. Nodular goiter in thyroid ultrasound

Which means: it indicates an enlarged thyroid gland with heterogeneous flesh and nodules.

Interpretation: Toxic and non-toxic nodular goitre are distinguished, in the case of a toxic goiter, the nodules over-secrete hormones.

Thyroid doctor – endocrinologist or thyroidologist?

  1. Irregular border of changes in the thyroid gland ultrasound

Which means: the border of the focal change is clearly visible but wavy or interlocked.

Interpretation: A nodule with this border is “suspect” and therefore may be a malignant lesion.

Read more about treating thyroid tumors

  1. Spongy lesion on ultrasound of the thyroid gland

Which means: they are generally fluid-predominantly lithium-fluid changes.

Interpretation: most often such changes are mild.

  1. Multinodular hyperplasia on ultrasound of the thyroid gland

Which means: it results from numerous small merging changes.

Interpretation: most often indicates a mild lesion.

What does the thyroid gland suffer from?

  1. White knight changes in thyroid ultrasound

What they mean: These are small, hyperechoic changes in the inflamed thyroid parenchyma.

Interpretation: they most often indicate a benign lesion.

Symptoms of thyroid disease – see how to recognize them

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